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*This appliance is for Class
III correction and is used different
from a standard RPE.
Effective orthopedic maxillary
protraction is an innovative technique
for treating maxillary hypoplasia
in Class III patients.
Effective orthopedic maxillary
protraction includes three components:
1. 2-hinged rapid maxillary expander
for a greater anterior displacement
of maxilla.
2. Protocol of Alternate Rapid
Maxillary Expansions and
Constrictions (Alt-RAMEC) of maxilla
for better disarticulation of maxilla.
3. Maxillary protraction mask
More
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Previous “acrylic
bonded” expander installation
involved tedious and uncomfortable
isolation, etching and sealing
steps for anchor teeth. During
treatment the gingival would typically
become unacceptably inflamed, and
removal of this type of expander
was extremely painful. The DeLuke
Contoured Expander installs
in minutes, requires no teeth preparation,
and can be installed in all patients – even
those with short, tapering clinical
crowns. Root parallel sutural expansion
is optimized because of the maximum
anchorage achieved from the “cementation
caps.” The DCE is comfortable
to wear and allows for maintenance
of healthy gingival throughout
treatment. The DCE’s bandless
design eliminates the need for
a band inventory.
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The
RPE (rapid palatal expander)
is a fixed metal expander
soldered to bands on the first
molars and first bicuspids with
an .036 lingual wire connecting
the bands. It provides rapid
expansion of the mid-palatal suture
through daily activation of the
expansion screw. 1/4 turn of the
screw results in 1/4mm of expansion.
Typically .5mm of
lateral expansion per day is achieved
by instructing the patient to activate
the screw 1/4 turn in the morning
and 1/4 turn at night. Screws come
in 8, 11, and 13mm sizes.
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This adaptation
of the RPE is a good alternative
when rapid palatal expansion is
desired but the patient is in mixed
dentition or banding of the first
bicuspids might be a problem. Due
to the rigid nature of these appliances,
the 2 banded version is also a
good choice in cases with a difficult
path of insertion. The anterior
arms of the expansion screw are
soldered directly to the lingual
wires thus eliminating the need
for bicuspid bands.
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A fixed maxillary
expander that uses acrylic pads
and heavy lingual wires to apply
pressure to both the teeth and
the palatal tissue during expansion.
The lingual wires
are soldered to bands on the first
bicuspids and the first molars
and extend into the palate where
they are embedded in the acrylic
pads.
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Used as an alternative
to the removable Schwarz appliance,
this fixed metal expander provides
lateral expansion in the mandibular
arch. It is a good option when
patient cooperation might be an
issue.
A miniaturized version
of an RPE screw is placed lingual
to the anteriors. Heavy arms extend
back from the screw and are soldered
to bands on the first molars. Lingual
arms of .036 are also soldered
to the molar bands and extend forward
contacting the lingual of the bicuspids
or D's and E's.
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An ingenious alternative
to traditional expanders, the Super
Screw is a telescoping metal expander
that does away with the wire keys
used to activate the appliance
and replaces it with a small hex
wrench, making it more user friendly.
As the screw is
activated, a scale is revealed
with lines indicating every 2mm
of expansion so you can tell at
a glance how treatment is progressing.
They are available in 18, and 12mm
sizes.
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An alternative to
the banded design this fixed expander
uses posterior acrylic coverage
which is bonded directly to the
teeth. The posterior bite blocks
free up the occlusion removing
cuspal interferences.
Head gear tubes,
arch wire tubes, and reverse pull
hooks can all be added as desired.
The Bonded RPE is available with
the traditional RPE screws as well
as the Super Screwtm,
and the Compact RPEtm.
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This
fixed metal expander (also available
as a fixed/removable) is capable
of applying forces in numerous
directions depending upon how
it is activated.
The
four helical loops (two in the
first bicuspid region and two
in the second molar region) can
be activated in unison or individually
to achieve the desired results.
The appliance is soldered to
bands on the first molars and
lingual arms run from the bands
forward to the cuspids or first
bicuspids as desired.
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